Health advocates say for a relatively small amount of money millions of lives could be spared from disfiguring and crippling illnesses. So they’re calling on the Obama administration to target so-called neglected tropical diseases.
Dr. Peter Hotez, President of the Sabin Vaccine Institute and a professor at George Washington University, in Washington, D.C., called for increased funding this week in a New York Times op-ed piece Parasites in Paradise.
“Neglected tropical diseases are a group of parasitic and related infections that represent the most common infections of the world’s poor – the most common infections of people we call the bottom billion,” he says.
Hotez says there are more than a billion people living below the World Bank poverty line of (US) $1.25 a day.
“These are parasitic infections, particularly worm infections,” he says, including hookworm, roundworm and Schistosomiasis, elephantiasis, and river blindness.
Out of sight, out of mind
“They’re neglected for a number of reasons. One is the fact that they occur in the rural areas of these poor countries where tourists seldom venture. So that they’re sight unseen,” he says.
He calls them “forgotten diseases among forgotten people.”
“They also don’t get the attention of the global health policy makers, in part, because they tend not to be killer diseases. Rather than killing people, they slowly debilitate them and prevent them from achieving their full productivity,” says Hotez.
“Nor can they learn in school,” he adds, “because they’re too impaired from the infection. India loses a billion (US) dollars in economic losses annually from elephantiasis because people are too sick to work in the fields.”
Legacy of slavery
Neglected diseases are usually associated with regions in Africa and Asia. But he says, “They plague communities much closer to home” in the Western Hemisphere.
“Sadly,” he says, “these are tragic legacies of slavery. So the 11 million slaves that came over during the hundreds of years of the Middle Passage – went to places such as Brazil and the Caribbean, even to some extent the United States. And with that, these diseases gained a foothold here in the Americas.”
He says the poor in the Americas are just as “ignored” as the poor in Africa and Asia.
“We still have this incredible health disparity in the region in which hundreds of thousands, even millions, of people suffer from these parasitic infections and they’re our neighbors,” he says.
There’s an answer
“We, in collaboration with colleagues and other organizations, have been promoting a package of drugs that could be given at extremely low cost – for as little as 50 cents per person per year…. And we do this through an organization called the Global Network for Neglected Tropical Diseases.”
The organization works with the World Health Organization and the Inter-American Development Bank.
“These drugs are simple to administer once a year and they can make a huge difference to the lives of the poorest people in the regions. And because they are legacies of slavery, we think there’s also a moral imperative to taking on these diseases,” says Hotez.
The George Washington University professor estimates it would cost about (US) $20 million a year, a relatively small amount in terms of global health spending. And the tourists could foot the bill.
“Basically the cost of a dollar per tourist who visits, because there’s 20 million tourists roughly, who visit Caribbean every year. We could wipe out one of these tragic legacies of slavery,” he says.
Even in the U.S.
The poor in the United States, including African Americans and Hispanics, are not immune to such diseases.
He says, “I started to notice this amazing overlap between these neglected tropical diseases wherever poverty existed. And I started to think about poverty in the United States. We have incredible pockets of poverty in post-Katrina, Louisiana, in the Mississippi Delta, in our inner cities, along the border with Mexico, in Appalachia. We found diseases that closely resemble the neglected tropical diseases, although they’re not tropical in the classical sense.”
Instead, they’re called neglected infections of poverty.
“For example, there’s a parasitic worm infection,” he says, “that’s linked to asthma and developmental delays, where I estimated…that up to 3,000 African Americans, mostly kids, suffer from this infection. And yet it’s an infection that goes almost entirely undiagnosed.”
Another infection, Chagas disease, afflicts many poor Hispanics in the U.S.
He says, “(It’s) a heart infection that most physicians, when they see someone who has sudden cardiac death or has severe heart disease, don’t even think about doing a diagnostic test for Chagas disease.”
A similar situation exists with Cysticercosis, a parasitic brain infection that can cause epilepsy.
“These are not rare diseases. They’re incredibly common, but because they occur among voiceless people, we just never hear about them or think about them. The point being, that if these infections were occurring among wealthy people in the suburbs, we would never tolerate it,” says the president of the Sabin Vaccine Institute.
Hotez praises the Obama administration for responding to neglected tropical diseases, saying it’s been “terrific to date.”
“They’ve recognized the importance of these infections,” he says, “We’ve been talking to members of Congress and also the White House and USAID.”
This year, the U.S. is spending about (US) $65 on neglected tropical diseases. Next year, Hotez says, the Obama administration has proposed spending $155 million.